"More recently, a study appearing in the October 2004 issue of the Journal of the National Cancer Institute found that ductal lavage was ineffective at detecting breast cancer among women who had already been diagnosed with the disease. In the study, Seema A. Khan, MD, of the Lynn Sage Comprehensive Breast Center in Chicago, and colleague performed ductal lavage on 32 women who had been diagnosed with breast cancer, prior to mastectomy. They also performed ductal lavage on seven high-risk women before having preventive mastectomies. They found that ductal lavage detected atypical or cancerous breast cells in only five of the 38 cases. Further research is needed to determine the effectiveness of ductal lavage."
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The mean number of ducts lavaged was 1.4 per mastectomy specimen. From 29 breasts, the cytologic samples were evaluable for diagnosis.
"The data indicate that if the duct produces fluid, and if the cells are markedly atypical or malignant, the likelihood of disease is relatively high, but if the duct does not produce fluid, or if the cells are mildly atypical, the assurance that there is absence of disease is low," Dr. Khan said.
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since there are something like 12-14 lactiferous ducts in each breast, sampling 1.4 of them isn't going to do a very good job of screening for disease. It's like doing a mammogram of 10% of the breast and hoping to find cancer.
I'm skeptical that there will be any widespread use of ductal lavage for screening, but it's worth studying further in certain populations.
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